Moore, Randa A
Moore, Randa A is an sole proprietor health care provider with primary practice located at 2620 Forum Blvd Ste E , Columbia MO 65203-5454. She recently has only one registered license in Behavioral Health & Social Service Providers / Behavioral Analyst, which is considered as her primary health care specialty. Moore, Randa A can be contacted via phone (573) 514-8735.Contact Information
Primary practice address
2620 Forum Blvd Ste E
Columbia MO 65203-5454
Phone: (573) 514-8735
Fax: (573) 722-2133
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavioral Analyst | 103K00000X |
Profile Details
| NPI number | 1235689993 |
|---|---|
| LBN Legal business name | Moore, Randa A |
| Credentials | M.ED., BCBA, LBA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 6th, 2016 |
| Last updated | Jun 11th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235689993 | NPPES |
| Missouri | MEDICAID | 730081389 |
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